Predictors of Positive Head-Up Tilt Test in Patients with Suspected Neurocardiogenic Syncope or Presyncope

OH, J.H., et al .: Predictors of Positive Head-Up Tilt Test in Patients with Suspected Neurocardiogenic Syncope or Presyncope. Neurocardiogenic syncope is the most common cause of syncope in patients who present in outpatient clinics. Head-up tilt test (HUT) has been widely used to diagnose neurocardiogenic syncope. However, the HUT does not always produce a positive response in patients with suspected neurocardiogenic syncope. The aim of the present study was to assess the clinical history and characteristics of patients with suspected neurocardiogenic syncope or presyncope who undertook HUT, and to identify prognostic factors of a positive HUT response. During the first phase of HUT, patients were tilted to a 70-degree angle for 30 minutes. If the first phase produced a negative response, the second phase was subsequently performed involving intravenous isoproterenol administration. Of 711 patients, 423 (59.5%) patients showed a positive HUT response. In contrast to previous studies, this study showed that the vasodepressive type (76.6%) was the most common pattern of positive response, and that the rate of positive response during the first phase was low (7.1%). By multivariate analysis, the occurrence of junctional rhythm was found to be a predictor of an impending positive response in HUT   (P < 0.001)   . The shorter time interval between the last episode and HUT was also a predictor of positive response   (P = 0.0015)   . Younger age   (P = 0.0003)   and a history of physical injury during a syncopal episode   (P = 0.019)   were found to be associated with a positive response in the first phase of HUT. (PACE 2003; 26[Pt. I]:593–598)     

Kale Juice Improves Coronary Artery Disease Risk Factors in Hypercjlolesterolemiic Men

Objective To evaluate the effect of 3-month kale(Brassica oleracea acephala)iuice supplementation on coronary artery disease risk factors among hypercholesterolemic men.Methods Thkty-two men with hypercholesterolemia (>200 mg/dL)were recruited after annual health examinations among the faculty and staff at university.The subijects consumed 150 mL of kale iuice per day for a 12-week intervention period.Dietary and anthropomeu-ic assessments were performed and blood samples were collected to evaluate biochemical profdes before and after supplementation.Results Serum concentrations of HDL-cholesterol,and HDL-to LDL-cholesterol ratio were significantly increased by 27%(P<0.0001)and 52%(P<0.0001),respectively.The LDL-cholesterol concentration and the atherogenic index were significantly reduced by 1O%(P=0.O007)and 24.2%(P<0.0001),respectively without affecting body mass index,waist and hip circumferences,or nutrient intakes after three months of supplementation.While there was no difference in the concentration of malondialdehvde,significant increase in glutathione peroxidase activity(P=0.0005)were accompanied by a significant increase in the serom selenium level(P=0.0132).It was also foand that the responses of these risk factors to kale inice administration were dependent on smoking status.Conelusion Regular meals supplementation with kale juice can favorably influence serum lipid profiles and antioxidant systems.and hence contribute to reduce the risks of coronary artery disease in male subjects with hyperlipidemia.     

Epstein-Barr virus-associated lymphoproliferative eruption with progression to large granular lymphocytic leukaemia

A 12-year-old Korean girl gave a 9-year history of recurrent necrotizing papules and vesicles on the face, scalp and extremities. Skin biopsy specimens showed an atypical lymphoreticular infiltrate with vasculitis in the dermis and subcutis. In situ hybridization demonstrated latent infection by Epstein-Barr virus (EBV) of the lymphoid cells in the dermis. The disease was diagnosed as an EBV-associated lymphoproliferative skin eruption presenting as recurrent necrotic papulovesicles. The patient subsequently developed large granular lymphocytic leukaemia of natural killer cell origin. Our observations suggest that a patient with an EBV-associated lymphoproliferative skin eruption presenting with recurrent necrotic papulovesicles might progress to develop leukaemia as well as lymphoma.     

各种不同年龄人参的皂苷含量及其抗小鼠肿瘤的作用(英文)

AIM: To compare the anticarcinogenic effects of fresh, white, and red ginseng (Panax ginseng C A Meyer) roots and their saponins. METHODS: Lung adenoma in newborn N : GP ( S) mice was induced by a subcutaneous injection of benzo(a)pyrene 0.5 mg. After weaning, ginseng powders or extracts were given in the drinking water for 6 wk. In the 9th wk the incidence and multiplicity of lung adenoma were counted. RESULTS: Anticarcinogenic effects were found in 6-year-dried fresh ginseng, 5- and 6-year white ginseng, and 4-, 5-, and 6-year-red ginseng powders. Anticarcinogenic effects were also found in 6-year-dried fresh ginseng, 5- and 6-year-white ginseng, and 4-, 5-, and 6-year-red ginseng extracts. The content of major ginsenosides Rb1, Rb2> RC. Rd,Re, Rf,Rg1 showed a little higher tendency in fresh or white ginsengs than red ginseng. This tendency was increased as the cultivation ages were increased. But there was no relationship was found between ginsenoside contents and preparation types or cultivation age     

Radioisotope synoviorthesis with Holmium‐166‐chitosan complex in haemophilic arthropathy

Summary. Radiosynoviorthesis is a safe and easy method for synovectomy in haemophilic arthropathy. Various agents have been used in radiosynoviorthesis, especially newly developed agent Holmium‐166‐chitosan complex has good clinical outcome. This study analysed clinical results and radiologic evaluation of radioisotope synoviorthesis using Holmium‐166‐chitosan complex in haemophilic arthropathy. From March 2001 to December 2003, 58 radiosynoviorthesis were performed in 53 haemophiliacs. The average age at procedure was 13.8 years. The Arnold and Hilgartner stage of the patients was from I to IV. Holmium‐166‐chitosan complex was injected in 31 ankle joints, 19 elbow joints and 8 knee joints. Average follow‐up was 33 months since primary procedure. The range of motion of each joint, frequency of intra‐articular bleeding and factor dose used were analysed for clinical assessment. There was no significant improvement of range of motion in affected joints. After procedure, the average frequency of bleeding of the elbow joint has decreased from 3.76 to 0.47 times per month, the knee joint from 5.87 to 1.12 times per month, and the ankle joint from 3.62 to 0.73 times per month respectively (P < 0.05). After treatment, the average coagulation factor dose injected was significantly decreased to 779.3 units per month from 2814.8 units per month before treatment (P < 0.001). Radioisotope synoviorthesis with Holmium‐166‐chitosan complex in haemophilic arthropathy is a very safe and simple procedure with the expectation of a satisfactory outcome without serious complication. It has excellent bleeding control effect on target joint and the need for substitution of coagulation factor concentrate can be reduced.     

Septal Dyskinesia and Global Left Ventricular Dysfunction in Pediatric Wolff‐Parkinson‐White Syndrome with Septal Accessory Pathway

LV Dysfunction in WPW Syndrome. Introduction: Echocardiographic studies have shown that some patients with Wolff‐Parkinson‐White (WPW) syndrome have myocardial dyskinesia in the segments precociously activated by an accessory pathway (AP). The aim of the present study was to determine the extent to which the AP contributes to global left ventricular (LV) dysfunction. Methods: Electrophysiological and echocardiographic data from 62 children with WPW (age at diagnosis = 5.9 ± 4.2 years) were retrospectively analyzed. Results: The left ventricular ejection fraction (LVEF) of patients with septal APs (53 ± 11%) was significantly lower than that of patients with right (62 ± 5%) or left (61 ± 4%) APs (P = 0.001). Compared to patients with normal septal motion (n = 56), patients with septal dyskinesia (n = 6) had a reduced LVEF (61 ± 4% and 42 ± 5%, respectively) and an increased LV end diastolic dimension (P < 0.001 for both comparisons). Multivariate analysis identified septal dyskinesia as the only significant risk factor for reduced LVEF. All 6 patients with septal dyskinesia had right septal APs, and a preexcited QRS duration that was longer than that of patients with normal septal motion (140 ± 18 ms and 113 ± 32 ms, respectively; P = 0.045). After RFA there were improvements in both intraventricular dyssynchrony (septal‐to‐posterior wall motion delay, from 154 ± 91 ms to 33 ± 17 ms) and interventricular septal thinning (from 3.0 ± 0.5 mm to 5.3 ± 2.6 mm), and a significant increase in LVEF (from 42 ± 5% to 67 ± 8%; P = 0.001). Conclusion: The dyskinetic segment activated by a right septal AP in WPW syndrome may lead to ventricular dilation and dysfunction. RFA produced mechanical resynchronization, reverse remodeling, and improvements in LV function. (J Cardiovasc Electrophysiol, Vol. 21, pp. 290–295, March 2010)     

Application of fluoride iontophoresis to improve remineralization

Summary  Iontophoresis is generally used to maximize the therapeutic action of drugs in medicine. This technique can be used to improve the remineralization effect of topical fluoride applications in dentistry. The aim of this study was to compare the remineralization effect of fluoride iontophoresis (FI) with the conventional fluoride application (CFA) method in vitro . Sixty bovine enamel specimens were divided into three groups: no fluoride treatment, CFA and FI. Fluoride was applied to the demineralized specimens for 4 min in each experimental group. The types of fluoride system used for application were 1·23% acidulated phosphate fluoride gel (12 300 p.p.m. F, pH 3·5) and 2% sodium fluoride solution (9050 p.p.m. F, pH 7) in the experimental groups. All the specimens were then placed in a remineralizing solution for 24 h. This cycle was repeated five times. An iontophoresis device (0·4 mA, 12 V) was used in the FI groups. The efficacy of this technique was evaluated by measuring changes in the surface microhardness and lesion depth of the specimens using confocal laser scanning microscope (CLSM). Data were analysed using anova and Tukey's post hoc test ( P  <   0·05). Although the FI groups showed higher ΔVHN than the CFA groups, there were no significant differences between these fluoride application methods ( P  >   0·05). When the lesion depth was measured using CLSM imaging, there was also no significant difference between the FI and CFA groups ( P  >   0·05). In conclusion, FI was not significantly superior to CFA in terms of the remineralization effect.